[Improvement Project to Increase Self-Care Implementation Rates Among Hemodialysis Patients]

Patients undergoing hemodialysis require adequate self-care ability to balance disease control with daily life activities. Inadequate self-care may lead to complications such as dyspnea, electrolyte imbalance, and catheter-related infections, increasing the risk of re-hospitalization. Based on a situational assessment and cause analysis, the authors identified the self-care implementation rate among hemodialysis patients to be only 65.8%. The major contributing factors included incomplete delivery of health education by nursing staff, inconsistent handover of education evaluation results information, patients' limited absorption of verbally delivered health education, and the absence of appropriate, practical educational support tools.

This project was designed to improve the rate of successful self-care implementation among hemodialysis patients using diversified improvement strategies to reduce repeated hospitalizations and enhance patient quality of life.

A health education evaluation and handover checklist, a catheter care manual, educational videos, teaching models, and an app-based interactive quiz game on catheter-related infection prevention were developed. Through inter-professional collaboration, a food water-content chart was designed, home care experiential learning sessions were conducted, and a discharge passport was provided to integrate health education content and establish continuous care records.

After implementation of the project interventions, the self-care implementation rate among hemodialysis patients increased from 65.8% to 90.5%, achieving the project's targeted goal.

Integrating visual materials, multimedia educational tools, and experiential learning courses has the potential to enhance the effectiveness of health education and learning motivation among hemodialysis patients, thus improving their self-care ability. In addition, these strategies may reduce the time required by nursing staff to deliver health education and thus improve the efficiency of clinical nursing care.